Fill and Sign the With Alternative Beneficiaries Form

© 2013 - U.S. Legal Forms, Inc. NEBRASKA REVOCABLE TRANSFER ON DEATH DEED [Husband and Wife / Two Individuals With Alternative Beneficiaries] Control Number: NE- 03-82 I. TIPS ON COMPLETING THE FORMSThe form(s) in this packet may contain “form fields” created using Microsoft Word or Adobe Acrobat (“.pdf” format). “Form fields” facilitate completion of the forms using your computer. They do not limit your ability to print the form “in blank” and complete with a typewriter or by hand.It is also helpful to be able to see the location of the form fields. Go to the View menu, click on Toolbars, and then select Forms. This will open the Forms toolbar. Look for the button on the Forms toolbar that resembles a shaded letter “a”. Click this button and the form fields will be visible. By clicking on the appropriate form field, you will be able to enter the needed information. In some instances, the form field and the line will disappear after information is entered. In other cases, it will not. The form was created to function in this manner.II. NOTICE TO OWNER(S) / TRANSFEROR(S):1. You should carefully read all the Warnings at the end of this Deed. 2. This Deed must be recorded (a) within thirty (30) days after being executed ; (b) before the transferor’s death; and (c) in the public records in the office of the register of deeds of the County for the property is located. 3. This form must be recorded before your death(s), or it will not be effective.4. After this transfer on death deed is recorded, it can be revoked only by an effective revocatory instrument recorded prior to the death of the transferor(s) and may not be revoked by a revocatory act taken against or on the original or a copy of the recorded transfer on death deed.5. The execution and recordation of this transfer on death deed does not limit the effect of a transfer of the property by the transferor(s). III. DISCLAIMERThese materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the State of Nebraska. All information and Forms are subject to this Disclaimer: All forms in this package are provided without any warranty, express or implied, as to their legal effect and completeness. Please use at your own risk. If you have a serious legal problem, we suggest that you consult an attorney in your state. U.S. Legal Forms, Inc. does not provide legal advice. The products offered by U.S. Legal Forms (USLF) are not a substitute for the advice of an attorney.THESE MATERIALS ARE PROVIDED “AS IS” WITHOUT ANY EXPRESS OR IMPLIED WARRANTY OF ANY KIND INCLUDING WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF INTELLECTUAL PROPERTY, OR FITNESS FOR ANY PARTICULAR PURPOSE. IN NO EVENT SHALL U.S. LEGAL FORMS, INC. OR ITS AGENTS OR OFFICERS BE LIABLE FOR ANY DAMAGES WHATSOEVER (INCLUDING WITHOUT LIMITATION DAMAGES FOR LOSS OR PROFITS, BUSINESS INTERRUPTION, LOSS OF INFORMATION) ARISING OUT OF THE USE OF OR INABILITY TO USE THE MATERIALS, EVEN IF U.S. LEGAL FORMS, INC. HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. Revocable Transfer on Death Deed Page 1 of 4 After Recording, return to: Name: Address: REVOCABLE TRANSFER ON DEATH DEED [Husband and Wife / Two Individuals to Individual]OWNER(S) / TRANSFEROR(S): ,whose address is , and , whose address is , husband and wife, TRANSFER UPON THEIR DEATH, the following property to the beneficiaries named below:LEGAL DESCRIPTION OF THE PROPERTY: We designate the following PRIMARY BENEFICIARY, if the beneficiary survives us: , whose mailing address is . Revocable Transfer on Death Deed Page 2 of 4If our PRIMARY BENEFICIARY does not survive us, we designate the following ALTERNATE BENEFICIARIES to take the property as tenants in common: , whose mailing address is and , whose mailing address is .At our death, a beneficiary takes the property subject to all conveyances, encumbrances, assignments, contracts, mortgages, liens, and other interests to which the property is subject at the time of the death of the last Transferor / Owner.Prior to the death of the Transferor(s) / Owner(s), and each of them, they, or the survivor of them, have the right to revoke this deed.Executed on the day and years set forth below.Date: Date: Signature of Owner / Transferor Signature of Owner / Transferor Print or Type Name Print or Type Name SELF-PROVING AFFIDAVIT I, and , the transferors, sign our names to this instrument this day of ,20 , and being first duly sworn, do hereby declare to the undersigned authority that we sign and execute this transfer on death deed to transfer our interest in the described real property and that we sign it willingly or willingly direct another to sign for us, that we execute it as our free and voluntary act for the purposes therein expressed, that we are eighteen years of age or older or not at this time a minor, and that we are of sound mind and under no constraint or undue influence. (Transferor’s Signature) (Transferor’s Signature) Print or Type Name Print or Type Name Revocable Transfer on Death Deed Page 3 of 4 We, and , the witnesses, sign our names to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the transferor signs and executes this transfer on death deed to transfer his or her interest in the described real property and that he or she signs it willingly or willingly directs another to sign for him or her, and that he or she executes it as his or her free and voluntary act for the purposes therein expressed, and that each of us, in the presence and hearing of the transferor, hereby signs this deed as witness to the transferor's signing, and that to the best of his or her knowledge the transferor is eighteen years of age or older or is not at this time a minor and the transferor is of sound mind and under no constraint or undue influence.Signature of Witness Signature of Witness Print or Type Name Print or Type NameState of Nebraska, County of Subscribed, sworn to, and acknowledged before me by and , Owner / Transferors and and , witnesses, this day of , 20 . Notary Public Type or Print Name My commission expires: Revocable Transfer on Death Deed Page 4 of 4 WARNINGS Pursuant to Nebraska Revised Statutes 76-3410, the following Warnings are included as part of this transfer on death deed:WARNING: The property transferred remains subject to inheritance taxation in Nebraska to the same extent as if owned by the transferor at death. Failure to timely pay inheritance taxes is subject to interest and penalties as provided by law.WARNING: The designated beneficiary is personally liable, to the extent of the value of the property transferred, to account for Medicaid reimbursement to the extent necessary to discharge any such claim remaining after application of the assets of the transferor's estate. The designated beneficiary may also be personally liable, to the extent of the value of the property transferred, for claims against the estate, statutory allowances to the transferor's surviving spouse and children, and the expenses of administration to the extent needed to pay such amounts by the personal representative.WARNING: The Department of Health and Human Services may require revocation of this deed by a transferor, a transferor's spouse, or both a transferor and the transferor's spouse in order to qualify or remain qualified for medicaid assistance.